北京城郊老人阿尔茨海默病评定量表认知部分中文版评分分布模式研究  

Distribution of baseline scores of the Alzheimer＇ s Disease Assessment Scale-Cognitive subscale among the elderly in Beijing

作　　者：王华丽[1] 于欣[1] 陈玉芳[1] 李海东[1] 贺军[1] 

机构地区：[1]北京大学精神卫生研究所、卫生部精神卫生学重点实验室,100191

出　　处：《中华神经科杂志》2009年第5期310-313,共4页Chinese Journal of Neurology

基　　金：北京市科学技术委员会“十五”攻关协作研究项目“早期老年期痴呆临床应用量表规范化研究”子课题（H010210550113）

摘　　要：目的探讨阿尔茨海默病评定量表认知部分（ADAS—Cog）中文版评分在健康老人中的分布模式及其影响因素，并考查ADAS—Cog评分区分轻度AD和健康老人的灵敏度和特异度。方法纳入健康老人（NC组）1616名、非痴呆易混淆老年患者（ND组）125例及AD患者310例（符合NINCDS—ADRDA很可能AD诊断标准，轻度201例，中度109例）为被试，所有被试接受ADAS—Cog测查。结果NC组不同年龄组和不同受教育年限组问评分差异均有统计学意义，分别以80岁以上组和受教育年限为0～5年组评分最高。NC组ADAS—Cog总分与年龄、受教育年限有关，差异具有统计学意义（F=14．34、113．27，均P〈0．01）；轻度AD组ADAS-Cog评分与年龄和受教育年限无关；中度AD组和ND组ADAS-Cog总分与受教育年限有关，差异具有统计学意义（F=4．18、8．72，均P〈0．05）。ADAS—Cog评分能在一定程度上区分不同年龄组（曲线下面积0．69—0．82）和不同受教育组（曲线下面积0．75～0．88，以≥15年组最高）轻度AD与健康老人。结论ADAS．Cog中文版总分在健康老年人群中的分布与年龄和受教育年限有关；ADAS—Cog适用于我国AD患者认知功能评估；ADAS-Cog评分在一定程度上可有效区分轻度AD与健康老人，尤其适用于高文化水平者。Objective To investigate the distribution pattern of the ADAS-Cog scores among the elderly in Beijing and to evaluate the application of ADAS-Cog in distinguishing patients with mild Alzheimer＇s disease （AD） and healthy elderly. Methods In total, 1616 healthy elderly （NC）, 125 elderly patients with non-AD disorders （ND）, and 310 patients with probable AD including 201 patients with mild AD and 109 patients with moderate AD （by NINCDS-ADRDA criteria） were recruited in the study and their cognitive performance was measured by the ADAS-Cog. Results In NC group, those older than 80 years and those with less than 5 years schooling scored highest. There was statistically significant correlation between the total scores of the ADAS-Cog and age and duration of schooling in NC group （ F = 14. 34, 113.27 ,both P 〈0.01 ）. No correlation was suggested in the mild AD group. The total score of ADAS-Cog was significantly associated with duration of sehooling in both moderate AD and ND groups （F = 4. 18, 8.72, both P 〈 0. 05 ）. The total score of ADAS-Cog differentiated the patients with mild AD from NC healthy elderly with AUC ranging from 0.69 to 0. 82 in each subgroup by age, and from 0. 75 to 0. 88 in subgroups by durations of schooling with the highest AUC of 0. 88 in the subgroup having more than 15 years of schooling education. Conclusions The ADAS-Cog score in the healthy elderly is significantly associated with age and duration of schooling education. The ADAS-Cog can be applied in the cognitive assessment of Chinese AD patients. The total score of ADAS-Cog could efficiently differentiate patients with mild AD from healthy elderly, especially in subjects with higher education level.

关 键 词：阿尔茨海默病 认知 心理测定学 

分 类 号：R686[医药卫生—骨科学]